BACKGROUND: Over the last years, growing resistance of gonorrhea to quinolones has emerged worldwide. Currently, cases with resistance to oral and parenteral third-generation cephalosporins are increasingly reported. Because gonorrhea is not a notifiable infection in Germany, data on epidemiology and antimicrobial surveillance of gonorrhea are scarce. We present the results of N. gonorrhoea testing at the University Hospital Dresden over the course of ten years. PATIENTS AND METHODS: The results of cultural and nucleic acid amplification testing of gonorrhea and accompanying infections of 1,850 smears between 2001 and 2010 were analyzed retrospectively. RESULTS: Among 181 patients (mean age 30.4 years) 159 had positive PCR analyses for gonorrhea and 50 positive cultures of Neisseria gonorrhoea. The rate of ciprofloxacin resistance was high (in 46% of all isolates), primarily in men. Resistance to cefotaxime and ceftriaxone could not be detected so far. In 40% of the cases at least one accompanying urogenital infection occurred, predominantly with Chlamydia trachomatis. CONCLUSIONS: Similar to other regions of Germany, a high percentage of resistance to quinolones was found in gonorrhea, but not to cephalosporins. Additionally, accompanying infections were frequent and warrant screening. In the light of recent cases of resistance to cephalosporins currently emerging in Europe, cultural diagnosis of gonorrhea should definitely be intensified by all means. The results should be integrated into a surveillance system.
BACKGROUND: Over the last years, growing resistance of gonorrhea to quinolones has emerged worldwide. Currently, cases with resistance to oral and parenteral third-generation cephalosporins are increasingly reported. Because gonorrhea is not a notifiable infection in Germany, data on epidemiology and antimicrobial surveillance of gonorrhea are scarce. We present the results of N. gonorrhoea testing at the University Hospital Dresden over the course of ten years. PATIENTS AND METHODS: The results of cultural and nucleic acid amplification testing of gonorrhea and accompanying infections of 1,850 smears between 2001 and 2010 were analyzed retrospectively. RESULTS: Among 181 patients (mean age 30.4 years) 159 had positive PCR analyses for gonorrhea and 50 positive cultures of Neisseria gonorrhoea. The rate of ciprofloxacin resistance was high (in 46% of all isolates), primarily in men. Resistance to cefotaxime and ceftriaxone could not be detected so far. In 40% of the cases at least one accompanying urogenital infection occurred, predominantly with Chlamydia trachomatis. CONCLUSIONS: Similar to other regions of Germany, a high percentage of resistance to quinolones was found in gonorrhea, but not to cephalosporins. Additionally, accompanying infections were frequent and warrant screening. In the light of recent cases of resistance to cephalosporins currently emerging in Europe, cultural diagnosis of gonorrhea should definitely be intensified by all means. The results should be integrated into a surveillance system.
Authors: Frederik Tilmann von Rosen; Antonella Juline von Rosen; Falk Müller-Riemenschneider; Inken Damberg; Peter Tinnemann Journal: Int J Environ Res Public Health Date: 2018-01-10 Impact factor: 3.390